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Fix dementia care – NHS and care homes

April 29 2016

This report published by the Alzheimer’s Society marks the second phase of a campaign looking at the experiences of people with dementia in a range of health and care settings. It contains the results of a survey of care home managers and the voices of people with dementia, their families and carers.

Seventy per cent of care home residents are living with dementia. Many will be in the later stages of the condition, may struggle to communicate, experience incontinence and live with a number of other long-term conditions. However, the Alzheimer’s Society research found that the rights of people with dementia under the NHS Constitution are not being respected.

The research also discovered that some GP practices are wrongly charging care homes, and the people who pay care home fees, for services that should be free on the NHS. In addition, people with dementia are often forced to wait months for vital secondary care like physiotherapy or mental health services. In their hour of need, some people with dementia, who have paid their taxes throughout their lives, are paying again to see a GP through their care home fees.

In the best examples, GPs have good relationships with care home staff and residents and do not charge to make regular visits to provide primary care. Access to secondary care services is also timely and effective, allowing people to manage their condition before reaching crisis point. In the worst cases, care homes are being charged up to £36,000 a year to provide services that should be free and available to all.

The report sets out recommendations for the government and NHS to improve the experiences of people with dementia in care homes, including:

End charging for providing access to a standard primary care service. Alzheimer’s Society is calling for the government to clarify the GP contract to ensure that GP practices do not charge for delivering a standard primary care service. This should include a clear definition of ‘core’ and ‘enhanced’ services.

Enforce the NHS Constitution to ensure that people with dementia living in care homes have equal access to secondary care services. Alzheimer’s Society is calling for CCGs and relevant NHS providers to develop effective local pathways to ensure that people with dementia who live in care homes have equal access to secondary services.

Enforce the NHS Constitution to ensure that people with dementia living in care homes have equal access to mental health services. Alzheimer’s Society is calling for CCGs and community mental health trusts to develop effective local pathways to ensure that people with dementia who live in care homes have equal access to mental health services.

Improve healthcare support for care homes. Alzheimer’s Society is calling for the government to support improvements in the availability of district and community nursing in care homes. This can help people with dementia receive better care, closer to home and reduce pressure on primary and secondary care.